Bovine Bone Mineral (bovine + bone_mineral)

Distribution by Scientific Domains
Medical Sciences100%

Kinds of Bovine Bone Mineral

  • deproteinized bovine bone mineral
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    Selected Abstracts

    The amount of newly formed bone in sinus grafting procedures depends on tissue depth as well as the type and residual amount of the grafted material

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2 2005
    Zvi Artzi
    Abstract Objectives: Bone replacement substitutes are almost unavoidable in augmentation procedures such as sinus grafting. The objective of the present study was to evaluate the osteoconductive capability of two different scaffold fillers in inducing newly formed bone in this procedure. Material and Methods: Sinus floor augmentation and implant placement were carried out bilaterally in 12 patients. Bovine bone mineral (BBM) was grafted on one side and , -tricalcium phosphate (, -TCP) on the contralateral side. Both were mixed (1:1 ratio) with autogenous cortical bone chips harvested from the mandible by a scraper. Hard tissue specimen cores were retrieved from the augmented sites (at the previous window area) at 12 months. Decalcified sections were stained with haematoxylin,eosin and the fraction area of new bone and filler particles was measured. In addition to the effect of the filler on new bone formation, the latter was tested to determine whether it correlated with the tissue depth and residual amount of the grafted material. Results: Bone area fraction increased significantly from peripheral to deeper areas at both grafted sites in all cores: from 26.0% to 37.7% at the , -TCP sites and from 33.5% to 53.7% at the BBM-grafted sites. At each depth the amount of new bone in BBM sites was significantly greater than that in TCP sites. However, the average area fraction of grafted material particles was similar in both fillers and all depth levels (, -TCP=27.9,23.2% and BBM=29.2,22.6%, NS). A significant negative correlation was found between bone area fraction and particle area fraction at the middle (p=0.009) and deep (p=0.014) depths in the , -TCP sites, but not at the BBM sites. Conclusion: At 12 months post-augmentation, the two examined bone fillers, , -TCP and BBM, promoted new bone formation in sinus grafting but the amount of newly formed bone was significantly greater in BBM-grafted sites. However, both exhibited similar residual grafted material area fraction at this healing period. This could imply that BBM possesses better osteoconductive properties. [source]

    Guided tissue regeneration combined with a deproteinized bovine bone mineral (Bio-Oss®) in the treatment of intrabony periodontal defects: 6-year results from a randomized-controlled clinical trial

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2 2010
    Andreas Stavropoulos
    Stavropoulos A, Karring T. Guided tissue regeneration combined with a deproteinized bovine bone mineral (Bio-Oss®) in the treatment of intrabony periodontal defects: 6-year results from a randomized-controlled clinical trial. J Clin Periodontol 2010; 37: 200,210. doi: 10.1111/j.1600-051X.2009.01520.x. Abstract Aim: To present the 6-year results of a randomized-controlled clinical trial evaluating guided tissue regeneration (GTR) combined with or without deproteinized bovine bone mineral (DBBM) in intrabony defects. Material & Methods: In each of 45 patients, one defect was treated with GTR combined with DBBM hydrated in saline (DBBM,) or gentamicin sulphate (DBBM+) or with GTR alone. Clinical parameters were recorded pre-surgery, at 1 and 6 years postsurgery. Results: Thirty-six patients/33 teeth were available for the 6-year control. Statistically significant clinical improvements were observed for all treatments. Clinical attachment level (CAL) gain averaged 2.5 mm (DBBM,), 4.1 mm (DBBM+), and 3.0 mm (GTR) at 1 year postsurgery, and remained stable over 5 additional years (2.3, 4.1, and 2.7 mm, respectively). Treatment did not appear to influence residual probing depths (PDs) or CAL gains at 6 years postsurgery, or the extent of PD and CAL change from 1 to 6 years, and did not associate with sites losing CAL during follow-up. No association of grafting with sites showing CAL gain 4 mm at the 1- or 6-year control was observed. Conclusion: The improvements in periodontal conditions obtained after GTR treatment with or without the adjunct use of DBBM can be preserved on a long-term basis. [source]

    Lateral ridge augmentation by the use of grafts comprised of autologous bone or a biomaterial.

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 12 2002
    An experiment in the dog
    Abstract Objective: The present investigation was performed to determine if a block of Bio-Oss® used as an onlay graft can be used as a scaffold for new bone formation. Material and methods: Five mongrel dogs were used. The mandibular premolars were extracted. On both sides of the mandible, the buccal bone plate was resected and defects, about 25 mm long, 8 mm high and 5 mm wide, were produced After 3 months of healing, a second surgical procedure was performed. In the left side, a block of Bio-Oss® was adjusted to the buccal bone wall. The graft had the shape of a cylinder and was retained with a miniscrew and covered with a collagen membrane. In the contra-lateral side of the mandible, a block biopsy was first obtained from the ascending ramus. This bone graft had the shape of a cylinder that was 8 mm in diameter and 3 mm thick. The graft was transferred to the experimental site, adjusted to the buccal wall, retained with a miniscrew, and covered with a membrane. The flaps were repositioned and closed with sutures to ensure a complete coverage of the experimental sites. After 6 months of healing, the dogs were sacrificed and the experimental sites dissected. The biopsies were processed for ground sectioning. The sections were stained in toluidine blue, examined in the microscope, and a number of histo- and morphometric assessments made. Results: The study demonstrated that cortical bone used as an onlay graft in the lateral aspect of the alveolar ridge, during a 6-month period of healing integrated with the host bone but underwent marked peripheral resorption. Thus, close to 30% of the height and 50% of the length of the graft was replaced with connective tissue. It was further observed that while the dimensions of a graft which contained a scaffold of cancellous bovine bone mineral remained unchanged, only moderate amounts of new bone formed at the base of this graft. Conclusion: Grafts of autologous cortical bone, placed on the surface of a one-wall defect, may undergo marked resorption during healing. A similar graft of Bio-Oss® may retain its dimension, and limited amounts of new bone will form within the biomaterial. [source]

    Alveolar ridge preservation with guided bone regeneration and a synthetic bone substitute or a bovine-derived xenograft: a randomized, controlled clinical trial

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 7 2010
    Nikos Mardas
    Abstract Objectives: The aim of this randomized, controlled clinical trial was to compare the potential of a synthetic bone substitute or a bovine-derived xenograft combined with a collagen membrane to preserve the alveolar ridge dimensions following tooth extraction. Methods: Twenty-seven patients were randomized into two treatment groups following single tooth extraction in the incisor, canine and premolar area. In the test group, the alveolar socket was grafted with Straumann Bone Ceramic® (SBC), while in the control group, Bio-Oss® deproteinized bovine bone mineral (DBBM) was applied. In both groups, a collagen barrier was used to cover the grafting material. Complete soft tissue coverage of the barriers was not achieved. After 8 months, during re-entry procedures and before implant placement, the horizontal and vertical dimensions of the residual ridge were re-evaluated and trephine biopsies were performed for histological analysis in all patients. Results: Twenty-six patients completed the study. The bucco-lingual dimension of the alveolar ridge decreased by 1.1±1 mm in the SBC group and by 2.1±1 in the DBBM group (P<0.05). Both materials preserved the mesio-distal bone height of the ridge. No differences in the width of buccal and palatal bone plate were observed between the two groups. The histological analysis showed new bone formation in the apical part of the biopsies, which, in some instances, was in direct contact with both SBC and DBBM particles. The coronal part of the biopsies was occupied by a dense fibrous connective tissue surrounding the SBC and DBBM particles. Conclusion: Both biomaterials partially preserved the width and the interproximal bone height of the alveolar ridge. To cite this article: Mardas N, Chadha V, Donos N. Alveolar ridge preservation with guided bone regeneration and a synthetic bone substitute or a bovine-derived xenograft: a randomized, controlled clinical trial. Clin. Oral Impl. Res. 21, 2010; 688,698. [source]

    Sinus augmentation analysis revised: the gradient of graft consolidation

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 10 2009
    Dieter Busenlechner
    Abstract Objective: Graft consolidation follows a gradient that reflects the properties of bone substitutes at sites of sinus augmentation. Here we present an analytical method to investigate the process of graft consolidation taking the distance from the maxillary host bone into account. Material and methods: We therefore evaluated histological specimens, 6 and 12 weeks after the sinus of minipigs was augmented with Bio-Oss®, a deproteinized bovine bone mineral, and Ostim®, an aqueous paste of synthetic nanoparticular hydroxyapatite. A curve was drawn that represents the changes in histomorphometric parameters within a given distance from the maxillary host bone. Results: Based on this curve, three regions of interest were defined: R1 (0,1 mm) the bridging distance where new bone is laid onto the host bone, R2 (2,3 mm) a region of osteoconduction where new bone exclusively grows on the biomaterial, R3 (4,5 mm) and a region of osteoconduction where bone formation has reached its maximal extension. Qualitative and quantitative analysis of the three regions can reveal differences in graft consolidation, depending on the bone substitutes and the observation period [Bone volume (BV) per tissue volume after 6 weeks: R1: 19±8.4% for Bio-Oss® and 42.9±13.2% for Ostim® (P=0.03), R2: 3±2.4% for Bio-Oss® and 14.7±9.5% for Ostim® (P=0.03), R3: 5±4.1% for Bio-Oss® and 5.3±5.3% for Ostim® (P=0.86). BV per tissue volume after 12 weeks: R1: 38.0±13.3% for Bio-Oss® and 53.3±6.6 for Ostim® (P=0.04), R2: 14±12.2 for Bio-Oss® and 26.4±11 for Ostim® (P=0.18), R3: 6.6±7 for Bio-Oss® and 10.7±5.8 for Ostim® (P=0.32) after 12 weeks]. Conclusion: Based on the graft consolidation gradient, the impact of bone substitutes to modulate the process of bone formation and the kinetic of degradation within a distinct region of the augmented sinus can be investigated. [source]

    Soft and hard tissue assessment of immediate implant placement: a case series

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 2 2007
    Gintaras Juodzbalys
    Abstract Objectives: The aim of this prospective study was to evaluate clinically and radiographically the success and esthetic result of immediate implant placement at the time of extraction. Material and methods: Twelve patients with 14 titanium screw-shaped implants (13,16 mm length and 4.3 or 5 mm diameters) were placed in the extraction sockets. Defects after implant placement were recorded, and then filled up with deproteinized bovine bone mineral, bioabsorbable collagen membrane, and absorbable pins. The defect was again re-evaluated at second-stage surgery. Clinical and radiographic parameters of the peri-implant conditions were assessed at the moment of prosthesis placement and at 1-year follow-up. Results: The cumulative implant survival and success rate was 100% after a 1-year observation period. Analysis of the esthetic result showed that the mean pink esthetic score (PES) was 11.1 (SD 1.35) at 1-year follow-up. At 1 year, 64.3% papillae had a score of 2 and the remaining 35.7% score 3 according to the Jemt (1997) papillary index. Optimal value of width of the keratinized mucosa was recorded in 13 (92.9%) implant cases in both periods of follow-up. At 1-year follow-up, the linear distance between implant-shoulder to the bone peaks remains stable with a mean of 2.62±0.2 mm at the mesial and 2.9±0.58 mm at the distal aspect. Conclusion: Careful evaluation of potential extraction sites before immediate implant installation promotes optimal implant esthetics. [source]

    Horizontal ridge augmentation using autogenous block grafts and the guided bone regeneration technique with collagen membranes: a clinical study with 42 patients

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 4 2006
    Thomas Von Arx
    Abstract Objective: To analyze the clinical outcome of horizontal ridge augmentation using autogenous block grafts covered with anorganic bovine bone mineral (ABBM) and a bioabsorbable collagen membrane. Material and methods: In 42 patients with severe horizontal bone atrophy, a staged approach was chosen for implant placement following horizontal ridge augmentation. A block graft was harvested from the symphysis or retromolar area, and secured to the recipient site with fixation screws. The width of the ridge was measured before and after horizontal ridge augmentation. The block graft was subsequently covered with ABBM and a collagen membrane. Following a tension-free primary wound closure and a mean healing period of 5.8 months, the sites were re-entered, and the crest width was re-assessed prior to implant placement. Results: Fifty-eight sites were augmented, including 41 sites located in the anterior maxilla. The mean initial crest width measured 3.06 mm. At re-entry, the mean width of the ridge was 7.66 mm, with a calculated mean gain of horizontal bone thickness of 4.6 mm (range 2,7 mm). Only minor surface resorption of 0.36 mm was observed from augmentation to re-entry. Conclusions: The presented technique of ridge augmentation using autogenous block grafts with ABBM filler and collagen membrane coverage demonstrated successful horizontal ridge augmentation with high predictability. The surgical method has been further simplified by using a resorbable membrane. The hydrophilic membrane was easy to apply, and did not cause wound infection in the rare instance of membrane exposure. [source]

    The effect of enamel matrix proteins and deproteinized bovine bone mineral on heterotopic bone formation

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 4 2006
    Nikolaos Donos
    Abstract Aim: To evaluate the osteoinductive potential of deproteinized bovine bone mineral (DBBM) and an enamel matrix derivative (EMD) in the muscle of rats. Material and methods: Sixteen rats were used in this study. The animals were divided in three groups. Group A: a pouch was created in one of the pectoralis profundis muscles of the thorax of the rats and DBBM particles (Bio-Oss®) were placed into the pouch. Healing: 60 days. Group B: a small pouch was created on both pectoralis profundis muscles at each side of the thorax midline. In one side, a mixture of EMD (Emdogain®) mixed with DBBM was placed into one of the pouches, whereas in the contralateral side of the thorax the pouch was implanted with DBBM mixed with the propylene glycol alginate (PGA , carrier for enamel matrix proteins of EMD). Healing: 60 days. Group C: the same procedure as group B, but with a healing period of 120 days. Qualitative histological analysis of the results was performed. Results: At 60 days, the histological appearance of the DBBM particles implanted alone was similar to that of the particles implanted together with EMD or PGA at both 60 and 120 days. The DBBM particles were encapsulated into a connective tissue stroma and an inflammatory infiltrate. At 120 days, the DBBM particles implanted together with EMD or PGA exhibited the presence of resorption lacunae in some cases. Intramuscular bone formation was not encountered in any group. Conclusion: The implantation of DBBM particles alone, combined with EMD or its carrier (PGA) failed to exhibit extraskeletal, bone-inductive properties. [source]

    Bone formation by enamel matrix proteins and xenografts: an experimental study in the rat ramus

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 2 2005
    Nikolaos Donos
    Abstract: The aim of this study was to evaluate whether the use of enamel matrix proteins with or without the use of deproteinized bovine bone influences bone formation when used as an adjunct to guided bone regeneration (GBR). Twenty rats, divided into four groups of five animals each, were used in this study. Group A1: A hemispherical PTFE capsule was placed empty on the lateral aspect of the mandibular ramus (GBR). At the contralateral side of the jaw, the capsule was filled with an enamel matrix derivative (EMD) before its placement. The healing period was 60 days. Group A2: The animals were treated in the same manner as in Group A1 but with a healing period of 120 days. Group B1: The animals were treated in the same manner as in Group A1 with the difference that deproteinized bovine bone mineral (DBBM) particles were packed in the capsule. At the contralateral side of the jaw, the capsule was filled with a mixture of EMD and DBBM. The healing period was 60 days. Group B2: The same treatment as in B1 but with a healing period of 120 days. The histological analysis revealed that in Groups A1 and A2 newly formed bone was covering a significant part of the empty capsules (GBR). The use of EMD in the capsule did not offer any added benefit to the use of the capsule alone in terms of new bone formation. At Groups B1 and B2, the presence of DBBM and/or EMD did not positively affect the amount of new bone formation. It can be suggested that neither the application of EMD nor the use of DBBM or the combination of EMD and DBBM results in enhanced amounts of bone formation in comparison with the GBR procedure alone. Résumé Le but de cette étude a été d'évaluer si l'utilisation des protéines de la matrice amélaire avec ou sans l'utilisation d'os bovin déprotéiné influençait la formation osseuse lorsqu'il était utilisé comme complément à la régénération osseuse guidée (GBR). Vingt rats divisés en groupe de cinq ont servi lors de cette étude. Le groupe A1 : une caspule hémisphérique en téflon a été placée vide sur la face latérale de la branche montante mandibulaire (GBR). Du côté contralatéral de la mandibule, une capsule remplie de dérivés de la matrice amélaire (EMD) a été saturée avant son placement. La période de guérison a été de 60 J. Le groupe A2 : les animaux ont été traités de la même manière que dans le groupe A1 mais avec une période de guérison de 120 J. Le groupe B1 : les animaux ont été traités de la même manière que dans le groupe A1 avec la différence que les particules d'os déprotéiné (DBBM) ont été placées dans la capsule. Dans le côté contralatéral de la mandibule, les capsules ont été remplies avec un mélange d'EMD-DBBM. La période de guérison était de 60 J. Le groupe B2 : le même traitement que B1 mais avec une période de guérison de 120 J. L'analyse histologique a révélé que dans les groupes A1 et A2 de l'os néoformé recouvrait une partie significative des capsules (GBR). L'utilisation de EMD dans la capsule n'ajoutait aucune amélioration à l'utilisation de la capsule seule en tant que néoformation osseuse. Dans les groupes B1 et B2, la présence de DBBM et de EMD ou des deux ne changeait pas de manière positive la quantité de nouvel os formé. Ni l'application de EMD ni l'utilisation de DBBM ou d'une combinaison EMD-DBBM ne résulte en une augmentation des quantités de formation osseuse comparée au processus de GBR utilisé seul. Zusammenfassung Das Ziel dieser Studie war, auszuwerten, ob Schmelzmatrixproteine mit oder ohne Verwendung von deproteiniertem bovinem Knochen die Knochenbildung beeinflussen, wenn sie als Zusatz bei der gesteuerten Knochenregeneration (GBR) verwendet werden. Zwanzig Ratten, aufgeteilt in 4 Gruppen mit je 5 Tieren, wurden für die Studie verwendet. Gruppe A1: Eine halbkugelförmige PTFE-Kapsel wurde leer auf die laterale Fläche des Unterkiefer Ramus platziert. Auf der gegenüberliegenden Seite wurde die Kapsel vor der Platzierung mit Schmelzmatrixproteinderivat (EMD) gefüllt. Die Heilungszeit betrug 60 Tage. Gruppe A2: Die Tiere wurden auf die gleiche Art behandelt wie in Gruppe A1, aber die Heilungszeit betrug 120 Tage. Gruppe B1: Die Tiere wurden behandelt wie in Gruppe A1 mit dem Unterschied, dass deproteinierte bovine Knochenpartikel (DBBM) in die Kapsel gepackt wurden. Auf der gegenüberliegenden Seite des Kiefers wurde die Kapsel mit einem Gemisch aus EMD und DBBM gefüllt. Die Heilungszeit betrug 60 Tage. Gruppe B2: Es wurden die selben Behandlungen wie in Gruppe B1 durchgeführt, aber die Heilungszeit betrug 120 Tage. Die histologische Analyse zeigte, dass in den Gruppe A1 und A2 neugebildeter Knochen einen signifikanten Anteil der leeren Kapseln bedeckte (GBR). Der Einsatz von EMD in der Kapsel ergab gegenüber der leeren Kapsel keinen zusätzlichen Nutzen bezüglich Bildung von neuem Knochen. Bei den Gruppen B1 und B2 hatte der Einsatz von DBBM und/oder EMD keinen positiven Effekt auf die Menge an neu gebildetem Knochen. Es kann angenommen werden, dass weder die Applikation von EMD noch die Verwendung von DBBM oder einer Kombination EMD und DBBM im Vergleich zum GBR Verfahren allein zu einer geseigerten Knochenbildung führt. Resumen La intención de este estudio fue evaluar si el uso de proteína de la matriz del esmalte con o sin el uso de hueso bovino desproteinizado influye en la formación de hueso cuando se usa junto a regeneración ósea guiada (GBR). En este estudio se usaron veinte Ratas divididas en 4 grupos de 5 animales cada uno. Grupo A1: Se colocó una capsula hemiesférica vacía en el aspecto lateral de la rama mandibular (GBR). En el lado contralateral de la mandíbula, la capsula se rellenó con un derivado de la matriz del esmalte (EMD) antes de su colocación. El periodo de cicatrización fue de 60 días. Grupo A2: Los animales se trataron de la misma manera que en el grupo A1 pero con un periodo de cicatrización de 120 días. Grupo B1: Los animales se trataron en el mismo modo que en el grupo A1 con la diferencia que las cápsulas se rellenaron de partículas de hueso bovino desproteinizado (DBBM). En el lado contralateral de la mandíbula, la cápsula se rellenó con una mezcla de EMD y DBBM. El periodo de cicatrización fue de 60 días. Grupo B2: El mismo tratamiento que en B1 pero con 120 días de cicatrización. El análisis histológico reveló que en los grupos A1 y A2 un hueso neoformado cubría una parte significativa de las cápsulas vacías (GBR). El uso de EMD en la cápsula no ofreció ningún beneficio adicional al uso de la cápsula por si sola en términos de formación de nuevo hueso. En los grupos B1 y B2, la presencia de DBBM y/o EDM no afectó positivamente a la cantidad de hueso neoformado. Se puede sugerir que ni la aplicación de EMD o el uso de DBBM o la combinación de EMD y DBBM resultaron en cantidades mejoradas de formación de hueso en comparación con el procedimiento de GBR por si solo. [source]

    Alveolar ridge augmentation with a prototype trilayer membrane and various bone grafts: a histomorphometric study in baboons

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 2 2005
    Dieter Busenlechner
    Abstract: Barrier membranes have become a standard treatment option in alveolar ridge augmentation prior to implant placement. However, non-resorbable membranes require secondary surgery and resorbable membranes show an unfavorable degradation profile. The purpose of this study was to evaluate the potential of a slowly biodegradable/bioresorbable prototype trilayer membrane (PTLM) for supporting bone regeneration in alveolar ridge augmentation. Clinically relevant cavities were made 3 months after the extraction of the first and second molars in each jaw of six baboons. Each animal was treated with four different regimens: (1) autogenous bone block (ABB) alone, (2) ABB+PTLM, (3) deproteinized bovine bone mineral (DBBM)+PTLM and (4) no treatment. After 9 months, the baboons were sacrificed and block sections of the augmented area were subjected to histologic and histomorphometric analyses. Newly formed bone areas were determined at a distance of 1, 3, 7 and 10 mm from crestal. The data showed a well-preserved ridge profile at the membrane-protected sites, whereas non-protected bone blocks and control sites underwent severe resorption resulting in knife-edge ridge profiles. Significant differences were found between ABB+PTLM and ABB (P=0.0137,0.0232). DBBM+PTLM also produced a larger bone area compared with ABB alone (P=0.0396,0.0439). No significant difference in bone area was detectable between ABB+PTLM and DBBM+PTLM (P>0.05). The present study supports the use of the slowly biodegradable/bioresorbable PTLM with autografts and DBBM for lateral ridge augmentation in this type of bone defects. Résumé Les membranes barrière sont devenues une option de traitement standard dans l'épaississement du rebord alvéolaire avant le placement des implants. Cependant, des membranes non-résorbables requièrent une seconde chirurgie et les membranes résorbables montrent un profil de dégradation peu favorable. Le but de cette étude a été d'évaluer le potentiel d'une membrane prototype de trois épaisseurs (PTLM) qui était biodégradable/biorésorbable lentement pour aider la régénération osseuse dans les épaississements de rebord alvéolaire. Des cavités cliniques ont été creusées trois mois après l'avulsion des premières et deuxièmes molaires de chaque mâchoire chez six babouins. Chaque animal a été traité de quatre manières différentes : 1) un bloc osseux autogène (ABB), 2) ABB+PTLM, 3) la partie minérale de l'os bovin déprotéiné (DBBM)+PTLM et 4) pas de traitement. Après neuf mois les babouins ont été euthanasiés et des coupes en blocs de la région épaissie ont été soumises aux analyses histologiques et histomorphométriques. Les zones d'os néoforméétaient déterminées à une distance de 1, 3, 7 et 10 mm du rebord alvéolaire. Les données ont montré un profil bien préservé au niveau des sites protégés par les membranes tandis que les blocs osseux non-protégés et les sites contrôles subissaient une résorption importante en un profil en forme de lame de couteau. Des différences significatives ont été trouvées entre ABB+PTLM et ABB (P=0,0137 àP=0,0232). DBBM+PTLM produisait aussi une aire osseuse plus importante comparéà ABB seul (P=0,0396 àP=0,0439). Aucune différence significative dans l'aire osseuse n'était visible entre ABB+PTLM et DBBM+PTLM (P>0,05). L'étude présente prône l'utilisation de la membrane prototype en trois couches biodégradable/biorésorbable lentement avec du minéral osseux bovin déprotéiné et des autogreffes pour l'augmentation latérale du rebord alvéolaire dans ce type de lésions osseuses. Zusammenfassung Muss vor der Implantation eine Knochenkammaugmentation durchgeführt werden, so ist die GBR mit der Membrantechnik als Standardbehandlung anzuführen. Nichtresorbierbare Membranen erfordern jedoch einen chirurgischen Zweiteingriff, und resorbierbare Membranen zeigen ein ungünstiges Verhalten während der Resorptionsphase. Das Ziel dieser Studie war, bei der GBR die Platzhalterfunktion des Prototyps einer dreischichtig aufgebautenen Membran (PTLM) zu untersuchen, die langsam biologisch abgebaut und resorbiert wird. Drei Monate nach der Extraktion der ersten und zweiten Molaren in jedem Kiefer von sechs Pavianaffen präparierte man klinisch relevante Kavitäten. Jedes Tier erhielt vier verschiedene Behandlungsmodalitäten: (1) nur autologe Knochenblöcke (ABB), (2) ABB+PTLM, (3) entproteinisiertes Knochenmineral vom Rind (DBBM)+PTLM und (4) keine Behandlung. Nach 9 Monaten opferte man die Paviane, entnahm von den aufgebauten Stellen Blockbiopsien und bereitete sie für die histologischen und histomorphometrischen Analysen auf. Auf die Suche nach Regionen mit neu gebildetem Knochen ging man in 1, 3, 7 und 10 mm Entfernung vom crestalen Knochen. Die Daten zeigten bei den mit Membranen abgedeckten und geschützten Stellen ein gut erhaltenes Alveolarkammprofil. Bei den ungeschützten Knochenblöcken und den Kontrollstellen kam es zu ausgedehnten Resorptionen, es resultierten messerscharf auslaufende Kammprofile. Man fand signifikante Unterschiede zwischen ABB+PTLM und ABB (P=0.0137 zu P=0.232). Auch DBBM+PTLM brachte, verglichen mit nur ABB, eine bessere Knochenauffüllung (P=0.0396 zu P=0.0439). Zwischen den Varianten ABB+PTLM und DBBM+PTLM fanden sich im untersuchten Kochen keine signifikanten Unterschiede (P>0.05). Diese Arbeit befürwortet bei der lateralen Knochenkammaugmentation eines solchen Knochendefektes den Einsatz eines Prototyps einer dreischichtigen Membran (PTLM), die langsam biologisch abgebaut und resorbiert wird, sowie von autologen Knochentransplantaten und entproteinisiertem Knochenmineral vom Rind. Resumen Las membranas de barrera se han convertido en una opción estándar de tratamiento en aumento de la cresta alveolar previo a la colocación del implante. De todos modos, las membranas no reabsorbibles requieren de un segundo procedimiento quirúrgico y las membranas reabsorbibles muestran un perfil de degradación desfavorable. El propósito de este estudio fue evaluar el potencial de un prototipo de membrana de tres capas (PTLM) biodegradable/biorreabsorbible para apoyar la regeneración ósea en el aumento de la cresta alveolar. Se realizaron cavidades clínicamente relevantes tres meses después de la extracción del primer y segundo molares de cada mandíbula de seis babuinos. Cada animal se trató con cuatro diferentes regímenes: (1) bloque de hueso autógeno (ABB) únicamente, (2) ABB+ PTLM, (3) hueso mineral bovino desproteinizado (DBBM)+PTLM y (4) sin tratamiento. Tras 9 meses se sacrificó a los babuinos y secciones en bloque del área aumentada se sometieron a análisis histológicos e histomorfométricos. Se determinaron las áreas de hueso neoformado a una distancia de 1, 3, 7, y 10 mm de la cresta. Los datos mostraron un perfil de la cresta bien preservado en los lugares protegidos por la membrana, mientras que los bloques de hueso no protegido y los lugares de control sufrieron una severa reabsorción resultando en unos perfiles de cresta en filo de cuchillo. Se encontraron diferencias significativas entre ABB+PTLM y ABB (P=0.0137 a P=0.0232). DBBM+PTLM también produjeron unas áreas mayores de hueso comparadas con ABB únicamente (P=0.0396 a P=0.0439). No se detectaron diferencias significativas entre ABB+PTLM y DBBM+PTLM (P>0.05). El presente estudio apoya el uso del prototipo de membrana de tres capas lentamente biodegradable/biorreabsorbible con autoinjertos y hueso mineral bovino desproteinizado para aumento lateral de la cresta en este tipo de defectos. [source]

    Bone formation following sinus grafting with autogenous bone-derived cells and bovine bone mineral in minipigs: preliminary findings

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 6 2004
    Gabor Fuerst
    Abstract: Bone formation in a sinus grafted with a cell-free scaffold requires the presence of local progenitor cells that differentiate into osteoblasts. The purpose of this study was to examine the effect of culture expanded autogenous bone-derived cells (ABC) with bovine bone mineral (BBM) on bone formation after single-stage sinus grafting in minipigs. Bone biopsies from the iliac crest were harvested 4 weeks prior to sinus grafting and ABC were culture expanded in vitro. The sinuses of five adult minipigs were grafted. In one sinus of each minipig the space between Schneider's membrane (SM) and the sinus wall was grafted with ABC (325,000 cells per sinus, on average) and BBM. In the other sinus, BBM alone was used. The animals were sacrificed after 12 weeks. One block of each grafted area was prepared by saw cutting and the amount of newly formed bone was analysed by micro-computed tomography (,-CT). The addition of ABC to BBM significantly increased the amount of newly formed bone compared with BBM alone on ,-CT analysis (ABC+BBM: 29.86±6.45% vs. BBM: 22.51±7.28% (P=0.016)). Bone formation was increased near SM (ABC+BBM: 20.7±4.5% vs. BBM: 15.43±3.62% (P=0.009)) and in the middle zone of the grafting material (ABC+BBM: 31.63±7.74% vs. BBM: 22.5±7.91% (P=0.001)), but not near the local host bone (ABC+BBM: 37.23±8.23% vs. BBM: 28.42±12.54% (P=0.15)). These preliminary findings indicate that supplementation of cell-free grafting material with culture expanded ABC can stimulate bone formation in areas with low bone-forming capacity. Résumé La néoformation osseuse dans un sinus grefféà l'aide d'un échafaudage acellulaire requiert la présence de cellules progénitrices locales qui se différencient en ostéoblastes. Le but de cette étude a été d'examiner l'effet de cellules dérivées de l'os autogène (ABC) avec expansion par culture avec un minéral osseux bovin (BBM) sur la formation osseuse après une greffe sinusale en une étape chez le mini-porc. Des biopsies osseuses de la crête iliaque ont été prélevées quatre semaines avant la greffe sinusale et les ABC ont été placées en culture in vitro. Les sinus de cinq mini-porcs adultes ont été greffés. Dans un sinus de chaque mini-porc l'espace entre la membrane de Schneider et la paroi sinusale a été greffé avec les ABC (en moyenne 325 000 cellules/sinus) et BBM. Dans l'autre sinus, BBM seul a été utilisé. Les animaux ont été euthanasiés après douze semaines. Un bloc de chaque aire greffée a été scié et la quantité d'os néoformé a été analysée par tomographie par micro-ordinateur (,-CT). L'addition d'ABC au BBM augmentait significativement la quantité d'os néoformé comparée à l'utilisation du BBM seul lors de l'analyse micro-CT [ABC+BBM : 29,9±6,5% vs BBM : 22,5±7,3% (P=0,016)]. La formation osseuse était augmentée près de la membrane de Schneiderian [ABC+BBM : 20,7±4,5 vs BBM : 15,4±3,6% (P=0,009)] et dans la zone moyenne du matériel greffé [ABC+BBM : 31,6±7,7% vs BBM : 22,5±7,9 (P=0,001)], mais pas dans la région proche de l'hôte (ABC+BBM : 37,2±8,2% vs BBM : 28,4±12,5% (P=0,150). Ces découvertes préliminaires indiquent que l'addition à un matériau acellulaire de ABC en culture d'expansion pouvait stimuler la formation osseuse dans des zones avec des faibles capacités de formation osseuse. Zusammenfassung Knochenformation nach Sinusaugmentation mit autologen Zellen knöchernen Ursprungs und bovinem Knochenmineral in Minipigs: erste Ergebnisse Die Bildung von neuem Knochen im augmentierten Sinus mit einer zellfreien Matrix benötigt lokale Progenitorzellen, welche sich in Osteoblasten differenzieren können. Das Ziel dieser Studie war, den Effekt von in Kultur gezüchteten autologen Zellen knöchernen Ursprungs (ABC) mit bovinem Knochenmineral (BBM) auf die Knochenbildung nach Sinusaugmentation in Minipigs zu untersuchen. Knochenbiopsien vom Beckenkamm wurden 4 Wochen vor der Sinusaugmentation entnommen und die ABC in vitro in einer Kultur vermehrt. Die Kieferhöhlen von 5 ausgewachsenen Minipigs wurden augmentiert. Bei einer Kieferhöhle jedes Minipigs wurde der Raum zwischen der Schneider'schen Membran und der Sinuswand mit ABC (325,000 Zellen pro Sinus in Durchschnitt) und BBM aufgefüllt. In der anderen Kieferhöhle wurde BBM allein verwendet. Die Tiere wurden nach 12 Wochen geopfert. Von jeder augmentierten Region wurde mittels Sägeschnitt ein Block präpariert und die Menge an neu gebildetem Knochen wurde durch Mikro-Computertomographie (,-CT) analysiert. Die Zugabe von ABC zu BBM bewirkte in der ,-CT Analyse eine signifikante Zunahme des neu gebildeten Knochens im Vergleich zu BBM allein (ABC+BBM: 29.86±6.45% gegenüber BBM. 22.51±7.28% (P=0.016)). Die Knochenbildung hatte im Bereich der Schneider'schen Membran (ABC+BBM: 20.7±4.5% gegenüber BBM: 15.43±3.62%(P=0.009)) und in der Mittelzone des Transplantatmaterials (ABC+BBM: 31.63±7.74% gegenüber BBM: 22.5±7.91% (P=0.001)) zugenommen, aber nicht in der Nähe des lokalen Wirtsknochens (ABC+BBM: 37.23±8.23% gegenüber BBM: 28.42±12.54% (P=0.15)). Diese ersten Resultate zeigen, dass der Zusatz von in Kultur gezüchteten ABC zu zellfreien Transplantatmaterialien die Knochenbildung in Regionen mit niedriger Knochenbildungskapazität stimulieren kann. Resumen La formación de nuevo hueso en un seno injertado con una estructura libre de células requiere la presencia de células progenitoras que se diferencien en osteoblastos. El propósito de este estudio fue examinar el efecto de células autógenas derivadas de hueso de cultivo expandido (ABC) con mineral de hueso bovino (BBM) en la formación de hueso tras un injerto del seno en una sola fase en minicerdos. Se tomaron biopsias de hueso de la cresta iliaca 4 semanas antes del injerto del seno y se cultivaron expandidamente las células ABC in vitro. Se injertaron los senos de 5 minicerdos. En un seno de cada minicerdo el espacio entre la membrana de Schneider y la pared del seno se injertó con ABC (325,000 células por seno, de media) y BBM. En el otro seno se uso BBM únicamente. Los animales se sacrificaron tras 12 semanas. Se preparó un bloque de cada área injertada por medio de una sierra y se analizó la cantidad de hueso neoformado por medio de micro tomografía computarizada (,-CT). La adición de ABC a BBM incrementó significativamente la cantidad de hueso neoformado comparado con BBM solo en el análisis de ,-CT [ABC+BBM: 29.86±6.45% vs. BBM: 22.51±7.28% (P=0.016)]. La formación del hueso se incrementó cerca de la membrana de Schneider [ABC+BBM: 20.7±4.5% vs. BBM: 15.43±3.62% (P=0.009)] y en la zona media de del material de injerto [ABC+BBM: 31.63±7.74% vs. BBM: 22.5±7.91% (P=0.001], pero no cerca del hueso huésped local [ABC+BBM: 37.23±8.23% vs. BBM: 28.42±12.54% (P=0.15)]. Estos hallazgos preliminares indican que la suplementación de injertos sin células con ABC de cultivo expandido puede estimular la formación de hueso en áreas con baja capacidad de formación de hueso. [source]

    Effect of GBR in combination with deproteinized bovine bone mineral and/or enamel matrix proteins on the healing of critical-size defects

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 1 2004
    Nikolaos Donos
    Abstract Objectives: To evaluate the effect of guided bone regeneration (GBR) in combination with or without deproteinized bovine bone mineral (DBBM) and/or an enamel matrix derivative (EMD) on the healing of critical-size calvarial defects. Material and methods: Forty rats were used. In all animals, a standardized critical-size calvarial defect was created surgically. The animals were randomly allocated into 4 groups of 10 animals each. Group A: One calvarial defect was left untreated, while the galeal and the cerebral aspect of the contralateral defect were covered with a bioresorbable membrane (GBR). Group B: One calvarial defect was filled with EMD, while the contralateral defect was treated with GBR and EMD. Group C: One defect was filled with DBBM, while the contralateral defect was treated with combination of GBR and DBBM. Group D: One defect was filled with DBBM combined with EMD, while the contralateral defect was treated with combination of GBR, DBBM and EMD. The healing period was 4 months. Five specimens from each group were macerated and the length, the width and the vertical dimension (thickness) of the remaining defect were evaluated by a stereomicroscope. The remaining specimens in each group were analyzed histologically. Results: The defects of the macerated specimens that were left untreated or were treated only by EMD, DBBM and combination of EMD and DBBM did not present predictably complete healing of the defects. All the defects where GBR was applied alone or combined with DBBM and/or EMD presented always complete healing (P<0.05). The combined use of GBR with EMD and/or DBBM did not offer any significant advantage above GBR alone in terms of healing of the length and the width of the defect. However, the vertical dimension of the defect was significantly higher (P<0.05) in the GBR-treated specimens of Groups C and D. The histological analysis supported these findings. Conclusion: The predictability of bone formation in critical-size defects depends mainly on the presence or absence of barrier membranes (GBR). The combined use with deproteinized bovine bone mineral and/or enamel matrix proteins did not significantly enhance the potential for complete healing provided by the GBR procedure. Résumé Le but de cette étude a été d'évaluer l'effet de l'association de la ROG avec ou sans minéral osseux bovin déprotéiné (DBBM) et/ou un dérivé de la matrice amélaire (EMD) sur la guérison de lésions crâniennes. Cette étude a eu recours à quarante rats. Chez tous les animaux, une lésion crânienne standardisée de grandeur critique a été créée chirurgicalement. Les animaux ont été répartis au hasard en quatre groupes de dix. Groupe A : une lésion crânienne fût laissée sans traitement, tandis que les deux côtés de la lésion latérale étaient recouvertes par une membrane biorésorbable (ROG), groupe B : une lésion crânienne remplie avec EMD tandis que la lésion contralatérale était traitée avec GBR et EMD, groupe C : une lésion remplie avec DBBM et la lésion contralatérale traitée par GBR et DBBM, Groupe D : une lésion remplie avec DBBM combinée avec EMD tandis que la lésion contralatérale a été traitée par une combinaison de ROG, DBBM et EMD. La période de guérison était de quatre mois. Cinq spécimens de chaque groupe ont été macérés et la longueur, la largeur et l'épaisseur de la lésion restante ont étéévaluées au stéréomicroscope. Les autres spécimens de chaque groupe ont été analysés histologiquement. Les lésions des spécimens macérés laissées sans traitement ou qui avaient été traitées seulement par EMD, DBBM et une combinaison de EMD et DBBM ne produisaient pas de manière prévisible une guérison complète des lésions. Toutes les lésions où la ROG était appliquée seule ou en association avec DBBM et /ou EMD présentaient toujours une guérison complète (p<0,05). L'utilisation conjointe de la ROG avec EMD et/ou DBBM n'offrait aucun avantage significatif sur la ROG seule en termes de guérison de la longueur et de la largeur de la lésion. Cependant la dimension verticale était significativement plus importante (p<0,05) dans les spécimens traités ROG des groupes C et D. L'analyse histologique a étayé ces découvertes. La prévision d'une formation osseuse dans les lésions de taille critique dépend essentiellement de la présence ou de l'absence de membranes barrières (ROG). L'utilisation combinée du minéral osseux bovin déprotéiné et /ou des protéínes de la matrice amélaire n'augmentait pas de manière significative le potentiel d'une guérison complète apportée par le processus ROG. Zusammenfassung Ziele: Die Untersuchung des Effekts der GBR in Kombination mit oder ohne deproteiniertem bovinem Knochenmineral (DBBM) und/oder einem Schmelzmatrix Derivat (EMD) auf die Heilung von Defekten mit kritischer Grösse. Material & Methoden: Es wurden 40 Ratten verwendet. Bei allen Tieren wurde auf der Calvaria chirurgisch ein standardisierter Defekt mit einer kritischen Grösse kreiert. Die Ratten wurden zufällig in 4 Gruppen mit je 10 Tieren aufgeteilt. Gruppe A: Ein Calvariadefekt wurde unbehandelt belassen, während der kontralaterale Defekt sowohl auf der cerebralen als auch auf der galealen Seite mit einer bioresorbierbaren Membran abgedeckt wurde (GBR). Gruppe B: Ein Calvariadefekt wurde mit EMD gefüllt, während der kontralaterale Defekt mit GBR und EMD behandelt wurde. Gruppe C: Ein Defekt wurde mit DBBM gefüllt, während der kontralaterale Defekt mit einer Kombination von GBR und DBBM behandelt wurde. Gruppe D: Ein Defekt wurde mit einer Kombination aus DBBM und EMD gefüllt, während der kontralaterale Defekt mit einer Kombination von GBR, DBBM und EMD behandelt wurde. Die Heilungszeit betrug 4 Monate. Fünf Präparate von jeder Gruppe wurden mazeriert und es wurden die Länge, die Breite und vertikale Dimension (Dicke) des verbleibenden Defekts unter dem Stereomikroskop ausgewertet. Die übrigen Präparate jeder Gruppe wurden histologisch analysiert. Resultate: Die Defekte der mazerierten Präparate, welche unbehandelt belassen oder nur mit EMD,DBBM und einer Kombination von EMD und DBBM behandelt worden waren, zeigten keine voraussagbare komplette Heilung der Defekte. Alle Defekte, bei denen GBR allein oder in Kombination mit DBBM und/oder EMD appliziert worden war, zeigten immer eine komplette Heilung (P>0.05). Die Kombination von GBR mit EMD und/oder DBBM bot gegenüber der GBR allein keine signifikanten Vorteile bezüglich Ausheilung der Länge und Breite der Defekte. Jedoch war die vertikale Dimension der Defekte bei den GBR behandelten Präparaten der Gruppen C und D signifikant grösser (P>0.05). Die histologische Analyse unterstützte diese Befunde. Schlussfolgerung: Die Voraussagbarkeit der Knochenbildung in Defekten mit kritischer Grösse hängt hauptsächlich von der Präsenz oder Absenz von Barrieremembranen (GBR) ab. Die kombinierte Verwendung von deproteiniertem bovinem Knochenmineral und/oder Schmelzmatrix Proteinen verbesserte das Potential für eine komplette Defektausheilung durch das GBR Verfahren nicht signifikant. Resumen Objetivos: Evaluar el efecto de GBR en combinación con o sin mineral óseo bovino desproteinizado (DBBM) y/o derivado de la matriz del esmalte (EMD) en la cicatrización de defectos de tamaño crítico en el calvario. Material y Métodos: Se usaron cuarenta ratas. En todos los animales se creó quirúrgicamente un defecto estándar de tamaño crítico en el calvario. Los animales se alojaron aleatoriamente en 4 grupos de 10 animales. Grupo A: Un defecto del calvario se dejó sin tratar, mientras que los aspectos galeales y cerebrales del defecto contralateral se cubrieron con una membrana biorreabsorbible (GBR). Grupo B: Un defecto del calvario se rellenó con EMD, mientras que el defecto contralateral se trató con GBR y EMD. Grupo C: Un defecto se rellenó con DBBM, mientras el defecto contralateral se trató con una combinación de GBR y DBBM. Grupo D: UN defecto se rellenó con DBBM combinado con EMD, mientras que el defecto contralateral se trató con una combinación de GBR, DBBM y EMD. El periodo de cicatrización fue de 4 meses. Cinco especímenes de cada grupo se maceraron, y se evaluó la longitud, la anchura y la dimensión vertical (grosor) del defecto remanente por estereomicroscopía. Los especímenes restantes de cada grupo se analizaron histológicamente. Resultados: Los defectos de los especímenes macerados que se dejaron sin tratar o se trataron solo con EMD, DBBM y una combinación de EMD y DBBM no presentaron una cicatrización completa predecible de los defectos. Todos los defectos en los que se aplicó GBR sola o combinada con DBBM y/o EMD siempre presentó cicatrización completa (p<0.05). El uso combinado de GBR con EMD y/o DBBM no ofreció ninguna ventaja significativa sobre GBR solo en términos de cicatrización de la longitud y la anchura del defecto. De todos modos, la dimensión vertical del defecto fue significativamente mayor (p<0.05) in los grupos tratados con GBR de los grupos C y D. Los análisis histológicos apoyaron estos hallazgos. Conclusión: La predictibilidad de la formación de hueso en defectos de tamaño crítico depende principalmente de la presencia o ausencia de membranas de barrera (GBR). El uso combinado con mineral óseo bovino desproteinizado y/o proteínas de la matriz del esmalte no realzaron significativamente el potencial para la cicatrización completa suministrado por el procedimiento de GBR. [source]

    Histological assessment of augmented jaw bone utilizing a new collagen barrier membrane compared to a standard barrier membrane to protect a granular bone substitute material

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 6 2002
    A randomized clinical trial
    Abstract: Successful bone augmentation requires predictable space maintenance and adequate exclusion of those cells that lack osteogenetic potential from the defect area. Natural bone mineral is considered to be osteoconductive and is used as space maker in combination with membrane barrier techniques. The aim of this study was to compare qualitative histological results achieved by using deproteinized bovine bone mineral (DBBM) as a space maintainer and a new collagen barrier (OssixÔ, test group) vs. the same bone substitute and the standard e-PTFE membrane (Gore-Tex®, control group). Twenty-eight patients were randomly assigned to the test or the control group. Seven months after augmentation procedures, biopsies were obtained at reentry and were analysed histomorphometrically. In all, 14 specimens of group I (test group, OssixÔ) and 13 specimens of group II (controls, PTFE-membranes) showed close qualitative similarity of their histologies. Histomorphometrically, total mineralized bone area was 42% ± 18% in group I vs. 39% ± 15% in group II. The unmineralized tissue area was 44% ± 15% vs. 46% ± 12% and the area of DBBM remnants 14% ± 9% and 15% ± 12%, respectively. The differences were statistically nonsignificant (Mann,Whitney test). The occurrence of barrier exposure did not interfere with the histological outcome either in the test or in the control group. The new collagen barrier combined with the DBBM provided qualitative bone regeneration comparable to the standard e-PTFE material combined with the same mineral. [source]